Hockessin Dance Center

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302-738-3838


2011 Registration Form Hockessin Dance Center, Inc. Please complete one for each child.

Student's Full Name:
 * required
Age: 
 * required
Birthday:
 * required
School and Grade:
 * required
Does the student have any allergies or medical conditions we should know?
Yes
No
(List if any)
New/Returning Student
New Student
Returning Student
How did you hear about HDC?
If Reffered by a friend, please enter the students name below.
Email Address:
 * required
Student's Email Address:
Parent/Guardian's Name:
 * required
Relationship to Student:
Full Address (including street, city, state and zip)
Home Phone:
 * required
Cell:
 * required
Additional Phone #:
Emergency Contact (other than parent/guardian)
 * required
Relationship to Student:
Phone #:
 * required
 
 
 
 
 

2012 Summer Schedule
to select multiple classes, hold Ctrl and click
or you can list classes in "Other"

2012 Dance Schedule
to select multiple classes, hold Ctrl and click
or you can list classes in "Other"

Other...
Pageant/Audition Dance Package
Private Lessons
Gift Certificate
Comments:
Photo Release

click here to read photo release form

Click below to be taken to a secure website if you would like to make a credit card payment. 
Cash and Checks will still be accepted by mail or at HDC 
 
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